Low self-esteem strongly associated with transaction sex

29 October 2019

Young women with low self-esteem are five times more likely to engage in transactional sex than other young women, South African survey suggests.

Young women welcoming people into a nightclub

A study examining the link between self-esteem and transactional sex among young women in rural South Africa has found that those with lower self-esteem are five times more likely to exchange sex for food, money, housing, material goods or improved social status.

Although previous research has found associations between low self-esteem and increased sexual risk among adolescents and young people, no studies have examined the links between lower self-esteem and young women’s vulnerability to transactional sex.

To examine this link, researchers analysed post-programme survey data from young women in rural parts of Mpumalanga Province – an area with high HIV prevalence, poverty and migration – who had participated in a three-year cash transfer trial, beginning in either 2011 or 2012. As part of this, a post-intervention survey was conducted between 2015 and 2017 and offered to all women (around 2,500) who had received cash transfers. Around 1,940 young women participated in the survey. They were aged between 17 and 26 (median age 19).

Self-esteem was measured using a sliding scale from 10 to 40. Among the sample, scores ranged from 17 to 38. Those who scored less than 28 were categorised as having lower self-esteem.

Participants were also asked whether they had exchanged sex for food, money, housing, material goods, or social status since the cash transfer trial had ended. In addition, they were asked about their education, financial security, gender attitudes, experience of intimate partner violence and negative childhood experiences (witnessing or experiencing physical or emotional abuse before the age of 18).

Approximately half (48%) of the young women taking part in the survey were found to have lower self-esteem and around 15% had engaged in transactional sex. Among participants with lower self-esteem, 25% had engaged in transactional sex, compared to 5% of participants with higher self-esteem. This remained true after adjusting for age, education, financial security, intimate partner violence, gender attitudes and adverse childhood experiences.

Because it is highly stigmatised, it is likely that some study participants will not have disclosed engaging in transactional sex, meaning levels are likely to be underreported. Despite this, these findings provide useful information for HIV prevention programmes that aim to reduce transactional sex among adolescent girls and young women.

Photo credit:
iStock/U.Ozel.Images. Photos are used for illustrative purposes only, they do not imply the health beahviour of any individuals depicted.

Written by Hester Phillips